Second Heart Sounds

Second Heart Sound: Fixed Splitting, Increased Aortic Intensity Sounds

This example shows a second heart sound (S2) with fixed splitting and an aortic component with increased intensity.

This pattern is seen in the presence of long-standing severe hypertension where the pressure in the aorta is markedly increased.

Once again, we are using fixed splitting of S2 to make it easier to concentrate on the relative intensities of the aortic and pulmonic component of S2.

This condition is caused by essential hypertension. Note the increased thickness of the left ventricular wall.

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The recommended auscultation position for the stethoscope is the Aortic position. For this sound, use stethoscope's Diaphragm.

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The recommended patient position is Sitting

Phonocardiogram

This waveform plots sound amplitude on the vertical axis against time on the horizontal axis.

Heart Animation

Lessons

1	Second Heart Sound - Physiologically Split #2
2	Second Heart Sound with Persistent Splitting
3	Second Heart Sound with Fixed Splitting
4	Second Heart Sound: Fixed Splitting, Increased Aortic Intensity
5	Second Heart Sound: Fixed Splitting, Decreased Aortic Intensity
6	Second Heart Sound and Late Systolic Click
7	Second Heart Sound and a Tumor Plop
8	Opening Snap and Second Heart Sound

Practice Drill

Listening Tips
A synopsis of important sound features and timing for this abnormality.
S2: Fixed splitting, increased intensity of aortic component.

CaseID	47
CourseID	24
CourseCaseOrder	4
ID	35